Individual
DR. MARCIE MATHES NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
5104 PENN AVE S, MINNEAPOLIS, MN 55419-1061
(612) 270-3261
Mailing address
5104 PENN AVE S, MINNEAPOLIS, MN 55419-1061
(612) 270-3261
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3027
MN
Other
Enumeration date
08/31/2006
Last updated
07/08/2007
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